Postnatal fever — endometritis and sepsis 🚨 🤰
🧠 Clinical mechanism: Postpartum uterine, urinary, wound or breast infection can lead to sepsis; retained placental tissue may perpetuate infection or haemorrhage.
🔎 Recognise
- Fever, pelvic pain, uterine tenderness, foul-smelling lochia, shivering or abnormal observations; assess haemorrhage and breastfeeding symptoms.
🛟 First assessment and action
- Prompt maternity assessment, ABCDE, early senior escalation and local maternal-sepsis pathway when indicated.
🧪 Investigations and reassessment
- FBC, lactate and cultures appropriate to severity; examine wound/uterus/breasts/urinary tract and request imaging if retained products suspected.
⚠️ Pitfall / escalation
- Normal postpartum leukocytosis complicates interpretation. Do not dismiss maternal fever as normal post-delivery pain or breast engorgement.
UK reference: Primary NHS/NICE/RCOG/GMC source.
Editorial draft, 7 November 2026: targeted source-supported educational summary, NOT independent consultant/pharmacist verification or a treatment protocol. Follow up-to-date BNF, NICE and local NHS pathways.
Related: Sepsis in pregnancy or postpartum 🚨 🦠 · Bleeding Postpartum